Evaluation of Tumor Associated Macrophages in Oral Squamous Cell Carcinoma Using Hla-Dr and Cd68 – An Immunohistochemistry Study

Abstract

Aim and Introduction: Oral squamous cell carcinoma is a malignant neoplasm which shows poor prognosis, highly metastatic in nature. Major components of the microenvironment, tumor-associated macrophages (TAM) have been shown to promote tumor progression by tumor invasion, migration, and angiogenesis. HLA-DR expressivity found in endothelial and epithelial origin, also reported in expression of tumor associated macrophages in squamous cell carcinomas, CD 68 expresses macrophage differentiation. Aim of the study was to analyze the tumor associated macrophages in oral squamous cell carcinoma using CD 68 and HLA-DR immunohistochemistry markers. 

Materials and methods: 20 samples of patients diagnosed with squamous cell carcinoma retrieved from the department of oral and maxillofacial pathology, subjected to immunohistochemistry techniques to access the expression pattern using markers like HLA-DR and CD-68. Immunostaining was assessed, tabulated and statistically analyzed using IBM SPSS. 

Results: Expression of CD68 was predominant in tumor stroma (50%) than malignant epithelial cells (5%). HLA-DR expression predominates in tumor stroma (65%) followed by malignant tumor cells (55%), observed in both good and moderate host response. No significant association of HLA DR expression in tumor islands according to host response (P=0.486) and pattern of invasion (P=0.247). 

Conclusion: A strong indication of tumor microenvironment in pathogenesis and clinical behaviour is reported leads to increases in immune reactivity. Our study focused on the expression of HLA DR and CD68 to study the possibility, an immunological prognostic factor, correlated with host response and pattern of invasion, helps in prediction of patient’s prognosis. The expression of HLA DR in malignant tumour islands along with CD68+ macrophages plays an important role in prognosis and disease-free survival.